Immunoglobulin formulation and method of preparation thereof

ABSTRACT

A stable aqueous pharmaceutical formulation comprising a therapeutically effective amount of an antibody, polysorbate 80, a buffer which inhibits polysorbate oxidation is described along with methods of making the preparation. Also described are formulations with high antibody concentrations which maintain fixed volumes and which may be used on patients of variable weight.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation of U.S. application Ser. No.12/572,978, filed Oct. 2, 2009, which is a continuation of U.S.application Ser. No. 10/773,406, filed Feb. 9, 2004, which claimspriority under 35 U.S.C. §119 to U.S. Provisional Application No.60/445,818 entitled “Immunoglobulin Formulation and Method ofPreparation Thereof” and filed on Feb. 10, 2003, the entire content ofwhich are hereby incorporated by reference in its entirety.

FIELD OF THE INVENTION

The invention is directed to stable, concentrated formulations ofproteins or antibodies, such as natalizumab, wherein the activity of theantibody is retained and also can be administered in a small volume andcan be administered to a subject of variable weight in need thereof.

BACKGROUND OF THE INVENTION

Antibody and protein formulations are known in the art. However,preparing protein formulations, such as antibody formulations, which arechemically and biologically stable, are fraught with challenges.Preparing formulations which are also not only stable but can maintain asmall volume (i.e., allowing for a small volume injection) even with anincreased concentration of protein, such as antibody, also isproblematic. The need for such formulations exist. For example,concentrated amounts of protein in a fixed volume that is also stablewould be especially beneficial to patients of variable weight.Administration of fluids to patients of variable weights may, forexample, have an adverse reaction. Development of such formulations hasbeen hindered by the proteins or the antibodies themselves, which have ahigh tendency to aggregate and precipitate.

SUMMARY OF THE INVENTION

Therefore, notwithstanding what has previously been reported in theliterature, there exists a need for improved methods of formulatingproteins and/or antibodies. There is also a need for stable formulationswith large concentrations of antibody or protein, where the activity ofthe antibody or protein is retained. Also needed are stable formulationsof concentrated protein which maintain a fixed volume. Applicantsdisclose herein stable compositions which can be further utilized toprepare antibody formulations, especially formulations with highconcentrations of antibody which do not precipitate out and are stablewhen stored at the recommended temperatures. The highly concentrated andstable antibody formulations will greatly aid physicians in treatingsubjects of variable weights.

One aspect of the invention provides for a stable, aqueouspharmaceutical formulation comprising an immunoglobulin (or otherprotein), a phosphate buffer, a polysorbate, and sodium chloride.Preferably the polysorbate is polysorbate 80, and preferably in theamount of about 0.001 % to about 2.0% (w/v). Most preferably thepolysorbate is present in the amount of about 0.02%. In anotherembodiment, the immunoglobulin or other protein is present in theformulation in an amount of about 0.1 mg/mL to about 200 mg/ml.Preferably the formulation is buffered to a pH between about 3.0 andabout 7.0 and most preferably is about 6.0∀0.5. The formulation ispreferably isotonic. The formulation may further comprise histidine.Preferably, the histidine is L-histidine.

In another aspect of the invention, the immunoglobulin of the aboveformulation is an anti-alpha-4 integrin antibody, such as natalizumab oranother humanized antibody or monoclonal antibody. This antibody can bepresent in a standard amount or in a concentrated amount, e.g., about 15mg/mL or more. Preferably, the natalizumab is present, in an amount fromabout 20 mg/mL to about 150 mg/mL. In instances wherein the formulationis present in a concentration of about 15 mg/mL or more, thisformulation is maintained in a fixed volume, for example, of about 125mL.

It is a further object of the invention to provide a method of treatinga patient with variable weight for a condition with a therapeutic amountof an immunoglobulin comprising administering a formulation as describedabove and herein, wherein the condition is treated by administration ofthe formulation. It is a further aspect of the invention that thecondition be one that is mediated by alpha-4 integrin, and in suchconditions the immunoglobulin is one which recognizes and binds toalpha-4 integrin, such as natalizumab.

A further aspect of the invention provides for a composition comprisinga sodium phosphate, a polysorbate, a protein and NaCl with a pH of6.0∀0.5, wherein the composition is stable when stored at 5EC to 8EC fora long period of time.

Another aspect of the invention provides for a method of preparing astable protein containing formulation comprising admixing sodiumphosphate, sodium chloride, a polysorbate and a protein and adjustingthe pH of the mixture with phosphoric acid to about pH 6.0∀0.5.

The protein may be lyophilized in the formulation of the presentinvention. The polysorbate is preferably polysorbate 80k, present in anamount of about 0.02% (w/v), and the protein is preferably natalizumab.The formulation may further comprise histidine.

Preferably, the protein is lyophilized in a solution comprising 5 mMhistadine, 20 mg/mL sucrose and 0.02% polysorbate 80 at a pH 6, and theprotein is natalizumab at a concentration of 20 mg/mL.

It is a further object of the invention to provide for an article ofmanufacture comprising a container holding the stable formulationdescribed above and herein.

Another aspect of the invention provides for a method for treating apatient with variable weight for a condition, comprising simultaneouslyor sequentially administering to the patient a therapeutically effectivecombination of a formulation described above and herein and a compoundor therapy effective against the condition.

It is a further aspect of the invention to provide a use of any of thestable formulations described herein for the preparation of a medicamentfor the treatment of a condition wherein the medicament is effective totreat said condition. This medicament may further comprise a secondcompound or therapy to treat the condition.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS OF THE INVENTION 1.Definitions

By “protein” is meant to include but is not limited to immunoglobulins,enzymes, receptor, and fragments thereof. Although discussion of theformulation is provided mainly in reference to an antibody orimmunoglobulin, other proteins are contemplated as interchangeable inthe formulations disclosed.

By “immunoglobulin” is meant to include but is not limited to anantibody and antibody fragment (such as scFv, Fab, Fc, F(ab′)₂), andother genetically engineered portions of antibodies. Depending on theamino acid sequence of the constant domain of their heavy chains,immunoglobulins can be assigned to different classes. There are fivemajor classes of immunoglobulins: IgA, IgD, IgE, IgG and IgM. Several ofthese may be further divided into subclasses (isotypes), e.g., IgG1,IgG2, IgG3, and IgG4; IgA1 and IgA2.The heavy chain constant domainsthat correspond to the different classes of immunoglobulins are calledalpha (α), delta (δ), epsilon (ε), gamma (γ), and mu (μ), respectively.The subunit structures and three-dimensional configurations of differentclasses of immunoglobulins are well known. Preferably, theimmunoglobulin recognizes and binds to alpha-4 integrin.

The term “antibody” is used in the broadest sense and specificallycovers monoclonal antibodies (including agonist and antagonistantibodies), antibody compositions with polyepitopic specificity, andantibody fragments (e.g., Fab, F(ab′)₂, scFv and Fv), so long as theyexhibit the desired biological activity. “Antibody” is meant to includepolyclonal antibodies, monoclonal antibodies, humanized antibodies,human antibodies, primatized7 antibodies and other antibodies producedvia genetic engineering.

The term “monoclonal antibody” as used herein refers to an antibodyobtained from a population of substantially homogeneous antibodies,i.e., the individual antibodies comprising the population are identicalexcept for possible naturally occurring mutations mat may be present inminor amounts. Monoclonal antibodies are highly specific, being directedagainst a single antigenic site. Furthermore, in contrast, toconventional (polyclonal) antibody preparations, which typically includedifferent antibodies directed against different determinants (epitopes),each monoclonal antibody is directed against a single determinant on theantigen. In addition to their specificity, the monoclonal antibodies areadvantageous in that they are synthesized by mammalian cell expressionsystems or transgenic technology, uncontaminated by otherimmunoglobulins. For example, the monoclonal antibodies to be used inaccordance with the present invention may be expressed in goats, asdescribed by Behboodi, et al. (2002) Transgenic cloned goats and theproduction of therapeutic proteins. In Principles of Cloning. ElsevierScience (USA); and Meade et at (1999). Expression of recombinantproteins in the milk of transgenic animals in Gene expression systems:using nature for the art of expression. J. M. Fernandez and J. P.Hoeffler ed., Academic Press, The modifier “monoclonal” indicates thecharacter of the antibody as being obtained from a substantiallyhomogeneous population of antibodies, and is not to be construed asrequiring production of the antibody by any particular method. Forexample, the monoclonal antibodies to be used in accordance with thepresent invention may be made by the methods described by Shepherd etal., Monoclonal Antibodies: A Practical Approach (Oxford UniversityPress. 2000).

The term “monoclonal antibodies” also includes “chimeric” antibodies(immunoglobulins) in which a portion of the heavy and/or light chain isidentical with or homologous to corresponding sequences in antibodiesderived from a particular species or belonging to a particular antibodyclass or subclass, while the remainder of the chain(s) is identical withor homologous to corresponding sequences in antibodies derived fromanother species or belonging to another antibody class or subclass, aswell as fragments of such antibodies, so long as they exhibit thedesired biological activity. For example, the ability to bind to alpha-4integrin. The “monoclonal antibodies” may also be isolated from phageantibody libraries using the techniques described for example inClackson et al., 1991 Nature 352: 624-628 and Marks et at., 1991 J. Mol.Biol., 222: 581-597. “Humanized” forms of non-human (e.g., murine,rabbit, bovine, equine, porcine, and the like) antibodies are chimericimmunoglobulins, immunoglobulin chains or fragments thereof (such as Fv,Fab, Fab′, F(ab′)₂ or other antigen-binding subsequences of antibodies),which contain minimal sequence derived from non-human immunoglobulin.For the most part, humanized antibodies are human immunoglobulins(recipient antibody) in which residues from a complementary determiningregion (CDR) of the recipient are replaced by residues from a CDR of anon-human species (donor antibody) such as mouse, rat or rabbit havingthe desired specificity, affinity and capacity. In some instances, Fvframework residues of the human immunoglobulin are replaced bycorresponding non-human residues. Furthermore, humanized antibody maycomprise residues which are found neither in the recipient antibody norin the imported CDR or framework sequences. These modifications are madeto further refine and optimize antibody performance. In general, thehumanized antibody will comprise substantially all of at least one, andtypically two, variable domains, in which all or substantially all ofthe CDR regions correspond to those of a non-human immunoglobulin andall or substantially all of the FR regions are those of a humanimmunoglobulin consensus sequence. The humanized antibody optimally alsowill comprise at least a portion of an immunoglobulin constant region(Fc), typically that of a human immunoglobulin.

The expression “linear antibodies” are also included by the general term“antibody” and are a pair of tandem Fd segments (VH-CH1-VH-CH1), whichform a pair of antigen binding regions. Linear antibodies can bebispecific or monospecific.

A “variant antibody” (also included by the generic term “antibody”) is amolecule which differs in amino acid sequence from a “parent” antibody'samino acid sequence by virtue of addition, deletion and/or substitutionof one or more amino acid residue(s) in the parent antibody sequence. Inthe preferred embodiment, the variant comprises one or more amino acidsubstitution(s) in one or more hypervariable region(s) of the parentantibody. For example, the variant may comprise at least onesubstitution, e.g., from about one to about ten, and preferably fromabout two to about five, in one or more hypervariable regions of theparent antibody. Ordinarily, the variant will have an amino acidsequence having at least 75% amino acid sequence identity with theparent antibody heavy or light chain variable domain sequences, morepreferably at least 80%, more preferably at least 85%, more preferablyat least 90%, and most preferably at least 95%. Identity or homologywith respect to this sequence is defined herein as the percentage ofamino acid residues in the candidate sequence that are identical withthe parent antibody residues, after aligning the sequences andintroducing gaps, if necessary, to achieve the maximum percent sequenceidentity. None of the N-terminal, C-terminal, or internal extensions,deletions, or insertions into the antibody sequence should be construedas affecting sequence identity or homology.

To analyze such properties, one should compare a Fab form of the variantto a Fab form of the parent antibody or a full length form of thevariant to a full length form of the parent antibody, for example, sinceit has been found that the format of the antibody impacts its activityin the biological activity assays disclosed herein. The variant antibodyof particular interest is one which displays at least about 10 fold,preferably at least about 20 fold, and most preferably at least about 50fold, enhancement in biological activity when compared to the parentantibody. The “parent” antibody is one which is encoded by an amino acidsequence used for the preparation of the variant. Preferably, the parentantibody has a human framework region and has human antibody constantregion(s). For example, the parent antibody may be a humanized or ahuman antibody.

An “isolated antibody” is one which has been identified and separatedand/or recovered from a component of its natural environment.Contaminant components of its natural environment are materials whichwould interfere with diagnostic or therapeutic uses for the antibody,and may include enzymes, hormones, and other proteinaceous ornonproteinaceous solutes. In preferred embodiments, the antibody will bepurified (1) to greater than 95% by weight of antibody as determined bythe Lowry method, and most preferably more than 99% by weight, (2) to adegree sufficient to obtain at least 15 residues of N-terminal orinternal amino acid sequence by use of a spinning cup sequenator, or (3)to homogeneity by SDS-PAGE under reducing or non-reducing conditionsusing Coomassie blue or, preferably, silver stain. Isolated antibodyincludes the antibody in situ within recombinant cells since at leastone component of the antibody's natural environment will not be present.Ordinarily, however, isolated antibody will be prepared by at least onepurification step.

“Antibody fragments” comprise a portion of an intact antibody, generallythe antigen binding or variable region of the intact antibody. Examplesof antibody fragments include Fab, Fab′, F(ab′)₂, and Fv fragments;diabodies; linear antibodies; single-chain antibody molecules; and multispecific antibodies formed from antibody fragments. “Single-chain Fv” or“sFv” antibody fragments comprise the VH and VL domains of antibody,wherein these domains are present in a single polypeptide chain.Generally, the Fv polypeptide further comprises a polypeptide linkerbetween the VH and VH domains which enables the sFv to form the desiredstructure for antigen binding.

The term “diabodies” refers to small antibody fragments with twoantigen-binding sites, which fragments comprise a heavy chain variabledomain (VH) connected to a light chain variable domain (VL) in the samepolypeptide chain (VH-VL). By using a linker that is too short to allowpairing between the two domains on the same chain, the domains areforced to pair with the complementary domains of another chain andcreate two antigen-binding sites. The route of antibody administrationis in accord with known methods and are well known, and may include, forexample, injection or infusion by intravenous, intraperitoneal,intracerebral, intramuscular, intraocular, intraarterial, orintralesional routes, or by sustained release systems. The antibody canbe administered continuously by infusion or by bolus injection.Therapeutic antibody compositions generally are placed into a containerhaving a sterile access port, for example, an intravenous solution bagor vial having a stopper pierceable by a hypodermic injection needle,“Pharmaceutically acceptable” recipients (e.g., vehicles, additives) arethose which can reasonably be administered to a subject mammal toprovide an effective dose of the active ingredient employed. A “stable”formulation is one in which the protein therein essentially retains itsphysical stability and/or chemical stability and/or biological activityupon storage. By “stable” is also meant a formulation which exhibitslittle or no signs of instability, including aggregation and/ordeamidation. For example, the formulations provided by the presentinvention may remain stable for at least two years, when stored asindicated at a temperature of 5-8° C.

Various analytical techniques for measuring protein stability areavailable in the art and are reviewed in Peptide and Protein DrugDelivery, 247-301 (Vincent Lee ed., New York, N.Y., 1991) and Jones,1993 Adv. Drug Delivery Rev. 10: 29-90, for examples. Stability can bemeasured at a selected temperature for a selected time period asexemplified by the provided examples. Storage of stable formulations ifpreferably for at least 6 months, more preferably 12 months, morepreferably 12-18 months, and more preferably for 2 or more years.

A protein, such as an antibody or fragment thereof, “retains itsphysical stability” in a pharmaceutical formulation if it shows no signsof aggregation, precipitation, deamidation and/or denaturation uponvisual examination of color and/or clarity, or as measured by UV lightscattering or by size exclusion chromatography.

A protein “retains its chemical stability” in a pharmaceuticalformulation, if the chemical stability at a given time is such that theprotein is considered to still retain its biological activity. Chemicalstability can be assessed by detecting and quantifying chemicallyaltered forms of the protein. Chemical alteration may involve sizemodification (e.g., clipping), which can be evaluated using sizeexclusion chromatography, SDS-PAGE and/or matrix-assisted laserdesorption ionization/time-of-flight mass spectrometry (MALDI/TOF MS),for examples. Other types of chemical alteration include chargealteration (e.g., occurring as a result of deamidation), which can beevaluated by ion-exchange chromatography, for example. An antibody“retains its biological activity” in a pharmaceutical formulation, ifthe biological activity of the antibody at a given time is within about10% (within the errors of the assay) of the biological activityexhibited at the time the pharmaceutical formulation was prepared asdetermined in an antigen binding assay, for example.

By “isotonic” is meant that the formulation of interest has essentiallythe same osmotic pressure as human blood. Isotonic formulations willgenerally have an osmotic pressure from about 250 to 350 mOsm.Isotonicity can be measured using a vapor pressure or ice-freezing typeosmometer, for example.

As used herein, “buffer” refers to a buffered solution that resistschanges in pH by the action of its acid-base conjugate components. Thebuffer of this invention has a pH in the range from about 3.0 to about7.5; preferably from about pH 4.0 to about 7.0; more preferably fromabout pH 5.0 to about 6.5; and most preferably has a pH of about6.0∀0.5. A pH of any point in between the above ranges is alsocontemplated.

In a pharmacological sense, in the context of the present invention, a“therapeutically effective amount” of an antibody refers to an amounteffective in the prevention or treatment of a disorder for the treatmentof which the antibody is effective. A “disorder” is any condition thatwould benefit from treatment with the antibody or protein. This includeschronic and acute disorders or diseases including those pathologicalconditions which predispose the mammal to the disorder in question.

“Treatment” refers to both therapeutic treatment and prophylactic orpreventative measures. Those in need of treatment include those alreadywith the disorder as well as those in which the disorder is to beprevented.

A “preservative” is a compound which can be included in the formulationto essentially reduce bacterial action therein, thus facilitating theproduction of a multi-use formulation, for example. Examples ofpotential preservatives include octadecyldimethylbenzyl ammoniumchloride, hexamethonium chloride, benzalkonium chloride (a mixture ofalkylbenzyldimethylammonium chlorides in which the alkyl groups arelong-chain compounds), and benzethonium chloride. Other types ofpreservatives include aromatic alcohols such as phenol, butyl and benzylalcohol, alkyl parabens such as methyl or propyl paraben, catechol,resorcinol, cyclohexanol, 3-pentanol, and m-cresol.

By “patient” or “subject” is meant to include any mammal. A “mammal,”for purposes of treatment, refers to any animal classified as a mammal,including but not limited to humans, domestic and farm animals, and zoo,sports, or pet animals, such as dogs, horses, cats, cows, and the like.Preferably, the mammal is human.

By “Antegren7” and is meant to include the antibody also known asAN100226 (antibody code number) or natalizumab (USAN name). Natalizumabis a recombinant, humanized anti-alpha-4 integrin antibody. Preferablythe disease or condition being treated in the mammal is one which ismodulated when a therapeutically effective dose of natalizumab isadministered.

By “stable” is meant a formulation which exhibits little or no signs ofinstability, including aggregation and/or deamidation. In addition,“stable” may also refer to a formulation which does not exhibit anysigns of instability for greater than or equal to two years, when storedas indicated at

GENERAL DESCRIPTION

In the discussion below and the examples to follow, formulations forstable antibody formulations are disclosed. Certain stable formulationsdisclosed have high concentrations of antibody but maintain a fixedvolume, wherein the antibodies in these formulations are stable and theantibody does not precipitate out of solution or aggregate. Proteinsother than antibodies are also contemplated for the high concentrationformulations.

Antibodies are typically administered to a subject (e.g., a human) at aconcentration of about 0.01 mg/mL to about 200 mg/mL. More typically,antibodies range in concentration from about 0.1 mg/mL to about 150mg/mL. However, instances exist when greater concentrations are requiredto be administered to a patient, e.g., about 15 to about 200 mg/mL, morepreferably about 15 mg/mL to 150 mg/mL, more preferably about 20 toabout 50 mg/mL, and most preferably about 20 mg/mL and any integer valuein between.

The antibody formulation may be administered to a mammal in need oftreatment with the protein, in accordance with known methods. Thesemethods may include, but are not limited to intravenous administrationas a bolus or by continuous infusion over a period of time, byintramuscular, intraperitoneal, intracerobrospinal, subcutaneous,intra-articular, intrasynovial, intrathecal, oral, topical, orinhalation routes. In preferred embodiments, the antibody formulation isadministered to the mammal by intravenous administration.

The appropriate dosage of the protein will depend, for example, on thecondition to be treated, the severity and course of the condition,whether the protein is administered for preventive or therapeuticpurposes, previous therapy, the patient's clinical history and responseto the protein, the type of protein used, and the discretion of theattending physician. The protein is suitably administered to the patientat one time or over a series of treatments and may be administered tothe patient at any time from diagnosis onwards. The protein may beadministered as the sole treatment or in conjunction with other drugs ortherapies useful in treating the condition in question. As used herein,two (or more) agents are said to be administered in combination when thetwo agents are administered simultaneously or are administeredindependently in a fashion such that the agents will actcontemporaneously.

In practicing the methods of this invention, the compounds of thisinvention may be used alone or in combination, or in combination withother therapeutic agents. In certain preferred embodiments, thecompounds of this invention may be co-administered along with othercompounds typically prescribed for these conditions according togenerally accepted medical practice. For example, the formulations ofthis invention can be administered in combination with other therapeuticagents or physical therapies for the treatment of rheumatoid arthritis,multiple schlerosis and Crohn's Disease.

2.1 Method of Making the Antibody Formula

The process can be altered as would be known to the skilled artisan, butgenerally would follow a procedure such as the following. Obtain anampoule from a working cell bank which contains cells which make theantibody or protein of interest. Prepare the inoculum. Culture orferment the cells with additional feedings as is necessary.Harvest/clarify the cells by centrifugation and/or filtration. This canbe done for example by concentrating the cells 10 fold by spiral woundfiltration. Filter by a 0.2 Φm intermediate filtration followed bypurification by protein A Sepharose Fast Flow7 (i.e., affinitychromatography) and reverse elution. The antibody containing compositionthen receives a treatment at pH 3.6-3.7. The mixture then receives aviral filtration followed by a concentration/diafiltration step. Thecomposition can then be purified by DEAE Sepharose Fast Flow (anionexchange). This step can be performed multiple times. From this point,the composition is then further concentrated followed by a purificationstep using Sephacryl S300HR7 (i.e., gel filtration chromatography)system, wherein the running buffer used is phosphate/NaCl. The antibodycontaining composition can be further concentrated for the highconcentration formulations (e.g., 20 mg/mL or more) if so desired. Theantibody containing composition is then further buffered and theconcentration adjusted by adding 0.02% (w/v) polysorbate 80. Thiscomposition then receives a final filtration using a 0.2 Φm filter andcan be dispensed at this point into 100 mL to 10 L polypropylenebottles. The antibody or immunoglobulin so obtained can then be QCtested and QA released.

The above can be done, for example for natalizumab, as diagrammed below:

200 L Material (5.0 mg/mL) 2000 L Material (5.0, 20 mg/mL) Ampoule fromWorking Cell Bank Ampoule from Working Cell Bank ↓ ↓ InoculumPreparation Inoculum Preparation ↓ ↓ Fermentation Fermentation(Additional Media Feed) ↓ ↓ Harvest/Clarification by filtration:Harvest/Clarification by Concentration 10x by spiral woundcentrifugation & filtration: filtration Concentration 10x by spiralwould filtration ↓ ↓ 0.2 μm Intermediate Filtration 0.2 μm IntermediateFiltration ↓ ↓ Purification by Protein A Purification by Protein ASepharose Fast Flow7 (Affinity Sepharose Fast Flow7 (AffinityChromatography) Chromatography) (Forward Elution) (Reverse Elution) ↓ ↓pH 3.7-3.8 treatment pH 3.6-3.7 treatment ↓ ↓ — Viral filtration ↓ ↓Concentration/Diafiltration Concentration/Diafiltration ↓ ↓ Purificationby DEAE Sepharose Purification by DEAE Sepharose Fast Fast Flow7 (AnionExchange Flow7 (Anion Exchange Chromatography) (Single Cycle)Chromatography) (Multiple Cycles) ↓ ↓ Concentration Concentration ↓ ↓Purification by Sephacryl Purification by Sephacryl S300HR7 S300HR7 (GelFiltration Chromatography) (Gel Filtration Chromatography) (RunningBuffer: phosphate/NaCl) (Running Buffer: histidine/NaCl) ↓ ↓ —(Additional concentration for 20 mg/mL) ↓ ↓ Buffer & ConcentrationBuffer & Concentration Adjustment Adjustment Phosphate/NaCl, (add 0.02%(w/v) polysorbate 80) 0.02% (w/v) polysorbate 80 ↓ ↓ 0.2 μm FinalFiltration 0.2 μm Final Filtration and and Dispensing (100 mL-1 LDispensing (100 mL-10 L polypropylene bottles) polypropylene bottles) ↓↓ QC Testing and QA Release of QC Testing and QA Release of Bulk BulkPurified AN100226 Purified AN100226

2.2 The Antibody Formulation

In one aspect of the invention, an immunoglobulin is formulated inconcentrations of about 1.7, 5.0, 10.0, 15.0, 20.0, 25.0, 30.0, 40.0 or50.0 mg/mL in 10 mM sodium phosphate, 140 mM NaCl (pH 6.0∀0.5) and 0.02%polysorbate 80. If necessary, the pH is adjusted to 6.0∀0.5 withphosphoric acid.

One example of the different formulations is displayed below.

Quantitative Composition: Phosphate Buffer Formulation

Unit Unit Unit Formula Formula Formula (per mL) (per mL) (per mL)Component Function 1.7 mg/mL 5.0 mg/mL 20 mg/mL Active Ingredient:Anti-α4 integrin Active 1.7 mg 5.0 mg  20 mg humanized monoclonalantibody Other Ingredients: Sodium Phosphate, Buffer and 1.4 mg 1.4 mg1.4 mg USP tonicity Sodium chloride, Buffer and 8.2 mg 8.2 mg 8.2 mg USPtonicity phosphoric acid, NF Adjust pH QS QS QS to 6.0 ∀ 0.5 Polysorbate80, NF Inhibit 0.2 mg 0.2 mg 0.2 mg protein aggregation Water forinjection, Diluent QS to 1 mL     QS to 1 mL     QS to 1 mL     USP

Any of the above formulations are optimally vialed in an aseptic vial.These vials can be, for example, Type I EP neutral glass vials (e.g.,5.0 or 20 mL fill vials) with Helvoet Pharma V9145/FM 157/1 gray butylrubber stoppers with aluminum seals. However other suitable asepticvials are also contemplated. For example, the formulations can bebottled as follows:

More specifically, natalizumab obtained for example by the proceduresdiscussed above, can be bottled as follows. Natalizumab 200 L and 2000 Ldrug product can be filled on a fully automated filling line equippedwith a vial washing, sterilization and depyrogenation tunnel. Stoppers,seals and filling equipment are washed and sterilized prior to use. Thisprocess allows for large scale tilling operations consistent with thevolumes produced from the 2000 L fermentation.

When necessary, the formulation buffer, about 10 mM phosphate, about 140mM NaCl, pH 6.0∀0.5, about 0.02% polysorbate 80, can be compounded in aClass 10,000 suite and used to dilute the bulk drug product to the finalconcentration. In-process specifications of concentration, pH anddensity are preferably reached prior to filtration.

The formulated natalizumab or other immunoglobulin can be sterilefiltered through a 0.2 μm Millipak filter into a stainless steel surgetank inside the sterile core. Filling, stoppering and capping ofnatalizumab is fully automated. In-process samples for bulk sterilityare collected; fill weight and headspace testing is conducted throughoutthe filling operation. Filled drug product is stored under refrigerationat about 2-8EC.

Filling occurs within a fully validated Class 100 sterile core. Thefilling line is validated to provide fill volumes within expectedtolerances for the 5.0 mL and 20 mL fill volumes. Comprehensiveenvironmental monitoring is conducted throughout the filling operationand reviewed to verify continual compliance with this standard. Mediafills are conducted on a quarterly basis to support aseptic fillingoperations.

Alternatively, the 200 L drug substance material produced can be bottledpursuant to the following example. Vials, filling needles, thefiltration assembly and tubing are prepared and sterilized prior to use.Stoppers can be prepared by the supplier. The stopper's are thensterilized prior to filling.

Natalizumab drug product or other protein is filled on a semi-automaticfilling line, with batch preparation of components, automated filling,immediate stoppering, and a subsequent capping operation. This operationis appropriate for small batch scale operations.

The final bulk solution is then sterile filtered through a 0.2 μmMillipak filter into a sterile glass receiving vessel within a Class 100environment. Regular calibration and in-process checks ensure that thefilling tolerance remains within ∀2%. Vials are stoppered and cappedimmediately. Filled drug product is preferably stored refrigerated at2-8EC.

The glass receiving vessel can be any number of vials, but can forexample be a 5.0 or 20 mL neutral glass vial Type I (EP) supplied by,for example, Epsom Glass or AMILCO or a 5.0 mL or 20 mL USP Type Iborosilicate glass vial, supplied by, for example Kimble or Wheaton.These vials can use any means of closure suitable. Vial closuresinclude, but are not limited to a 13 mm Helvoet Pharma V9145/FM 1.57/1grey butyl rubber stopper or a 13 mm and 20 mm Helvoet Pharma V9145/FM157/1 grey butyl rubber stopper or a 13 mm or 20 mm West 4432/50 graybutyl rubber stopper. The rubber-stoppered bottled is then sealed mosttypically using an aluminum seal, such as that manufactured by West.

Although the present invention has been described in detail withreference to examples below, it is understood that various modificationscan be made without departing from the spirit of the invention, andwould be readily known to the skilled artisan.

EXAMPLES Example 1 Selection of Polysorbate 80

The typical method of administering natalizumab is intravenous.Intravenous administration requires the final formulation to beisotonic. A formulation of AN100226 (natalizumab), 5 mg/mL in 50 mML-histidine 150 mM NaCl, pH 6.0 was initially chosen (Formulation #1).During a Phase II study, protein precipitation of the antibody wasobserved during the dilution and introduction of natalizumab into theclinical dosing apparatus. Polysorbate 80 was introduced into theformulation (Formulation #2) to resolve the observed proteinprecipitation. Preferably, the polysorbate for use with the presentinvention is low in peroxide, i.e., polysorbate from Sigma, Productnumber P6479, Lot Number 071K7283.

The two factors that have been shown to accelerate the precipitation ofthe AN100226 antibody are the presence of trace levels of silicone oiland denaturation at the air-liquid interface. The silicone oil wasintroduced into the product upon use of standard lubricatedpolypropylene syringes equipped with siliconized rubber stoppers. Theintroduction of the silicone oil is sufficient to cause discernibleantibody precipitation in Formulation # 1 upon gentle agitation and roomtemperature storage. The aggregation, deamidation and subsequentprecipitation caused by denaturation at the air-liquid interface hasbecome more discernable problematic with the drug being shipped to moreclinical sites. Both causes of protein precipitation have been resolvedby the addition of polysorbate 80 at a concentration of 0.02% (w/v).

Formulation #2 shows comparable stability to the histidine/NaClformulation (Formulation #1) in all protein characterization assays,while providing increased stability during product shipping and handlingin the clinical setting.

The addition of polysorbate 80 to the formulation also overcomes theproblem of precipitating or aggregating antibody when preparingformulations with higher protein content. Initial work focused onagitation-induced aggregation at high protein concentrations, including50 mg/mL. By subjecting the material to agitation using a vortex-typemixer, aggregated species were detected by size exclusion-highperformance liquid chromatography (SEC-HPLC). This model identifiedpolysorbate 80 as an effective inhibitor of aggregation, while sucroseand other buffering components had little beneficial effect.

The effectiveness of the addition of 0.02% (w/v) polysorbate 80 inpreventing agitation-induced precipitation at a protein concentration of5 mg/mL was assessed following addition of 10 μL of a 10% polysorbate 80solution to vials of natalizumab (Lot No. AN100226-0003). The vials wereshaken on their sides along with several vials of natalizumab inFormulation #1 at 150 rotations per minute in a horizontal plane. Within3 hours of this treatment at room temperature, the vials of Formulation#1 were laden with particles and appeared turbid while the vials with0.02% (w/v) polysorbate 80 remained clear and free of particles.

The observed aggregation is presumed to be caused by the air-surfaceinterface, as vials completely filled with AN100226 in the absence ofpolysorbate 80 were shaken for extended periods of time withoutadditional particle formation being induced.

An evaluation of the ability of 0.02% (w/v) polysorbate 80 to inhibitthe protein precipitation facilitated by trace levels of silicone wasconducted. A vial of natalizumab (Lot No. AN100226-0003) was adjusted to0.02% (w/v) polysorbate 80 and drawn into a commercially available,lubricated 60 mL polypropylene syringe. The material was allowed tostand for several hours at room temperature. Visual inspection confirmedthat no precipitation was occurring. The material was then filteredthrough a 0.2 μm filter into a 5-mL vial and inspected and found to besubstantially free of particles after several days, while vials treatedin the same manner in the absence of polysorbate 80 (Formulation #1)were laden with particles.

Example 2 Selection of the Phosphate Buffer

During release testing of the histidine placebo (containing 0.02% w/vpolysorbate 80), new trace impurities were detected. These impuritiesarose from degradation of polysorbate 80, apparently through anoxidation reaction involving metal ions and histidine. For activenatalizumab drug product, these trace impurities have been detected onlyafter storage at elevated temperatures (e.g., 25EC and 40EC). Thus, thedecision was made to modify the placebo and use phosphate to replacehistidine in the buffer. The lot of histidine used in the productplacebo was different than that used for the active natalizumab drugproduct lots AN100226-004 and AN100226-005. The impact of the source ofhistidine on polysorbate 80 degradation is discussed in greater detailinfra.

During testing of the placebo, trace impurities were detected in thehistidine/NaCl/0.02% (w/v) polysorbate 80 placebo (Formulation #2).These impurities were detected by their absorbency in the low wavelengthultraviolet region. The absorbency profiles from 200 to 400 nm forplacebo stored at 5EC, 25EC, and 40EC for one month were determined.These data indicate that the impurities are increasing as a function oftemperature.

The size exclusion HPLC method used to monitor antibody aggregation wasmodified to increase sensitivity for detection of the trace impuritiesby increasing the column load 5-fold to 300 μL, and the sample isapplied undiluted rather than 10-fold diluted. In addition, theabsorbency is monitored at 260 nm to reflect the absorbency maximum ofthe impurities. The method provides a tool to evaluate the presence ofthese trace impurities in both placebo and product, as the antibodyemerges much earlier in the elution profile.

Placebo and natalizumab final drug product formulated in Formulations #1and #2 were analyzed by the SEC-HPLC method described above. Analysis ofthe placebo in Formulation #1 spiked with polysorbate 80 to 0.02% (w/v)was performed just prior to chromatography. This shows the UV absorbencyof polysorbate 80, histidine, and salt in the absence of the traceimpurities. The broad peak at 16 minutes is associated with polysorbate80 while the peaks at approximately 26-27 minutes are attributed tohistidine and salt. The histidine/NaCl/0.02% (w/v) polysorbate 80placebo (Formulation #2) stored at 5EC for two months shows a markedincrease in the late eluting peaks which implicates polysorbate 80 inthe production of these impurities. In addition, the eluting at 16minutes disappeared, indicating that the polysorbate 80 has beendegraded.

AN100226 stored as bulk drug substance for approximately 5 months at 5ECin Formulation #1 was analyzed after spiking with polysorbate 80 to0.02% (w/v) just prior to chromatography. The antibody elutes at 16-18minutes rising these overload conditions. The remainder of the profileresembles the placebo with polysorbate 80 spike. The two-month stabilitysamples for natalizumab lot # AN100226-0004 were also analyzed by thismethod. The elution profile for the 5EC natalizumab sample indicates theabsence of any additional peaks and comparable levels of thehistidine/salt peaks at 26-27 minutes. The trace impurities are detectedat two months for the 25EC sample, and elevated levels are present forthe two month 40EC sample. Thus, these impurities have not been detectedin the clinical supplies, which are stored at 5EC. The appearance ofthese trace impurities is occurring much more rapidly in placebo than innatalizumab.

To avoid the formation of these impurities in the placebo, histidine wasreplaced with inorganic buffering components in the placebo formulation.The placebo product for the clinical trials is a sterile isotonicphosphate buffered solution with 0.02% (w/v) polysorbate 80 at pH 6.0.The substitution of histidine with phosphate was demonstrated tosignificantly reduce the rate of polysorbate 80 degradation. 100 μL ofthe phosphate/NaCl/0.02% (w/v) polysorbate 80 placebo formulation wasanalyzed by size exclusion HPLC monitored at 260 nm both at time zeroand after 3 days at 60EC. little change is seen in the SEC-HPLC profileas a result of this incubation. The SEC-HPLC profile for thehistidine/NaCl/0.02% (w/v) polysorbate 80 formulation following only twodays at 60EC shows significant levels of trace impurities related to thedegradation of polysorbate 80. These data demonstrate that thepolysorbate 80 degradation is significantly impeded by replacinghistidine with phosphate in the placebo formulation.

Example 3 Natalizumab Formulation with Polysorbate 80 and HistidineCombined

The mechanism by which these trace impurities are produced is drought tobe through a metal catalyzed oxidation of polysorbate (see Donbrow etal., 1978 J. Pharmaceutical Sciences, 67(12); 28). Donbrow describesthat autoxidation during storage occurs for different types ofpolysorbate (e.g., polysorbate 20). Light, temperatures and metal ionsalso impact autoxidation. Donbrow et al. (1978). It has been confirmedthat both histidine and polysorbate 80 are required for this reaction toproceed at a significant rate. Ajinomoto is the single histidine sourceused for formulation. However significant differences in the rate ofreaction between lots supplied by the Ajinomoto have been observed.

An additional factor that plays a role in accelerating the reaction isthe presence of metal. This was demonstrated by running a reaction at60EC for five days in glass vessel with 50 mM histidine (Lot No.R016A008) and 2% (w/v) polysorbate 80. Under these conditions, minimallevels of the trace impurities are produced for this histidine lot. Thereaction was then split into three vessels: (1) the first vesselremained as the control; (2) a gray butyl container closure (stopper)was added to the second vessel; and (3) a stainless steel needle wasadded to the third vessel. These reactions were then run for four daysat 60EC and analyzed by a UV scan from 200 to 400 nm. The reactionprogressed further over this time period in the presence of the needle.

Example 4 Evaluation of Impurities X Mouse Single-Dose Limit Test

The potential toxicity of these impurities was evaluated in a mousesingle-dose limit test. Histidine placebo and natalizumab samples inFormulation #2 stored at 40EC for six weeks were used because thesesamples provide the largest amount of the impurities. There were nosigns of toxicity due to the impurities. Preliminary data are providedin the non-clinical section of the submission.

The SEC-HPLC profiles for 100 μL injections of samples used in the mousesingle-dose limit test were determined. The natalizumab sample inFormulation #1 spiked with polysorbate 80 prior to analysis has little260 nm absorbing material eluting after 20 minutes. The peak eluting at34 minutes was found in this lot of natalizumab without polysorbate 80addition and therefore does not indicate polysorbate 80 degradation. Bycontrast, the placebo in Formulation #2 stored at 40EC for six weeks,showed complete degradation, as the total area under the curve was 12.8million μVXseconds. The natalizumab sample in Formulation #2 and storedat 40EC for six weeks had less complete degradation. The analysisconfirms that the samples stored at 40EC and tested in the mousesingle-dose limit test are laden with degraded polysorbate 80.

Example 5 Establishing Impurity Specifications

To assess if partially degraded polysorbate 80 is still capable ofpreventing antibody aggregation, Formulation #2 was heated to 60EC for 3days in the presence of a needle to convert all the polysorbate 80 tothe maximum levels of impurities. The reaction was confirmed to havedegraded all the polysorbate 80 by both SEC and reverse phase HPLC. Thismaterial was diluted one-to-one with a 10 mg/mL solution of AN100226 inFormulation #2 resulting in a solution containing 0.01% (w/v)polysorbate 80 and 50% of the maximum level of degraded polysorbate 80.These antibody solutions were exposed to both shaking and siliconizedsyringes tor several hours; aggregation of the antibody was prevented.The control samples exposed to the same conditions but withoutpolysorbate 80 showed significant precipitation.

It is concluded from this work that as long as no more than fiftypercent of the polysorbate 80 is degraded, this material can provide theappropriate environment to prevent antibody aggregation.

Although very little polysorbate degradation is occurring in the activedrug product, monitoring the isoelectric focusing (IEF) pattern is doneto confirm that this formulation is not compromising the antibody. IEFprofiles for the six week stability time points for 5EC, 25EC and 40ECstorage conditions were determined. Both the 5EC and 25EC samples arecomparable to the reference standard, with no evidence of any change inoverall charge of the protein. The 40EC sample showed the shift to amore acidic species typical of this product in a liquid formulationeither in the presence or absence of polysorbate 80.

To establish a relationship between the extent of polysorbate80degradation and the peak area from the SEC-HPLC, a dilution series forsix concentrations of degraded polysorbate 80 from 0 to 50% wasevaluated. Formulation #2 was heated to 60EC for 3 days with a needleand confirmed to be 100% degraded by SEC and reverse phase HPLC. Thereaction mixture was then diluted with AN100226 purified bulk inFormulation #1, freshly spiked with 0.02% (w/v) polysorbate 80 andanalyzed by SEC-HPLC. The SEC profiles were monitored at 260 nm.

The data from this dilution series were plotted by the total peak areaintegrated (μVXseconds) for the absorbency profile after approximately24 minutes as a function of the ratio of degraded polysorbate 80. Thisplot indicates that an area of less than 5 million μVXseconds representsabout a 50% loss of polysorbate 80 to degradation products. There is adirect relationship between the amount of oxidized polysorbate 80 addedand the peak area for the peaks eluting late in the chromatogram.

A preliminary limit for these trace impurities in natalizumab has beenestablished based on the mouse single-dose limit test, the antibodysolubility data with 50% degraded polysorbate 80, and estimates of theextent of the polysorbate 80 degradation. The method has been includedin the ongoing stability program and a limit has been established. Ifadditional lots are manufactured with histidine buffer, these limitswill be applied at time of release as well.

Limit: total area under the peaks after approximately 24 minutes is notto exceed 4×106 μVXseconds.

Example 6 1.7 mg/mL Natalizumab Formulation

-   -   1.7 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, USP    -   0.2 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 mL. With        preferred storage at 5-8EC.

Example 7 5.0 mg/mL Natalizumab Formulation

-   -   5.0 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, USP    -   0.2 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 mL. With        preferred storage at 5-8EC.

Example 8 20 mg/mL Natalizumab Formulation

-   -   20.0 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, USP    -   0.2 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 mL. With        preferred storage at 5-8EC.

Example 9 50.0 mg/mL Natalizumab Formulation

-   -   50.0 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, DSP    -   0.2 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 mL. With        preferred storage at 5-8EC.

Example 10 5.0 mg/mL Natalizumab Formulation

-   -   5.0 mg/mL natalizumab    -   140 mM NaCl    -   0.02% Polysorbate 80 (w/v)    -   10 mM sodium phosphate        Adjust pH to 6.0∀0.5 with phosphoric acid. Optimally store        formulation at about 5EC to about 8EC.

Example 11 10 mg/mL Natalizumab Formulation

-   -   10.0 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, USP    -   0.2 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 mL. With        preferred storage at 5-8EC.

Example 12 10 mg/mL Natalizumab Formulation

-   -   10.0 mg Natalizumab    -   1.4 mg Sodium phosphate, USP    -   8.2 mg Sodium chloride, USP    -   0.1 mg Polysorbate 80, NF        Adjust pH to 6.0∀0.5 with phosphoric acid, NF. QS to 1 ml. With        preferred storage at 5-8EC.

Example 13 20 mg/mL Natalizumab Formulation

-   -   20.0 mg/mL Natalizumab    -   140 mM NaCl    -   0.02% Polysorbate 80 (w/v)    -   10 mM sodium phosphate        Adjust pH to 6.0∀0.5 with phosphoric acid and bring volume to        125 mL. Optimally store formulation at about 5EC to about 8EC.

Example 15 Lyopholized Natalizumab Formulation

Additional liquid formulations of antibody at high concentration, from20-200 mg/mL may consist of phosphate or other suitable buffer (such ashistidine, citrate, acetate or succinate) in the concentration range of2 to 50 mM, to provide buffering in the pH range of 3.0 to 7.0. Mostpreferably, the pH is 6.0, +/−0.5. The addition of polyols (such assorbitol and mannitol), disaccharides (such as sucrose or trehalose) andamino acids (such as glycine) may be added in varying amounts withsodium chloride to maintain stability and provide an isotonic solution.The use of surfactants, such but not limited to the polysorbates, addstability when used in the range of 0.001 to 2%. To prepare a liquidformulation, natalizumab was concentrated to 65 mg/mL in 10 mM sodiumphosphate, 140 mM sodium chloride, pH 6, with about 0.06% polysorbate80. The resulting solution was slightly opalescent but withoutparticulates. The sample contained greater than 99% monomer with no highmolecular weight aggregate or low molecular weight species by SEC.

A stable lyophilized pharmaceutical formulation is provided. Becausephosphate buffer undergoes a pH change during freezing, it is necessaryto replace the phosphate with a different buffer. This buffer may becomprised of histidine, citrate or succinate,with the ability to buffereffectively in the pH range of 3.0 to 7.0, most preferably in the rangeof 6.0+/−0.5.

The use of polyols (such as mannitol) and sugars (such as sucrose) arenecessary to provide cryo- and lyo-protection. These polyols may be usedalone or in a combination to provide for stability and adjustment of thetonicity. Additionally, the use of amino acids (such as glycine), atlevels of 10-1000 mM may used to prevent aggregation.

Surfactants, such as polysorbates or poloxamers, may be used at levelsfrom 0.001% to 2.0% to provide for stability before lyophilization andafter reconstitution and to provide for more rapid reconstitution times.

The protein, following the final purification step, may be formulatedusing ultrafiltration for concentration and diafiltration for bufferexchange. The protein may also be formulated using column chromatographyfor buffer exchange. Some combination of these techniques may also beused.

In addition, the final desired protein concentration may be obtained byfilling at a protein and excipient concentration lower than desired andreconstitution at a smaller volume. For example, a 2.5 mL fill volume ofa 40 mg/mL solution may be used, followed by reconstitution with 1 mL toobtain a 100 mg/mL solution.

For example, natalizumab, at a concentration of 20 mg/mL, waslyophilized in a solution containing 5 mM histidine, 20 mg/mL sucroseand 0.02% polysorbate 80, pH 6. The solution was filled at 5 mL per vialinto 10 mL borosilicate glass vials and fitted with gray butyl rubberlyophilization stoppers. Lyophilization was done using a Virtis Gensismodel lyophilizer. The product was frozen at a shelf temperature of −60°C. for 10 hours and then the shelf temperature was raised to −40°.Primary drying was performed at a shelf temperature of −10° C. and achamber pressure of 100 mTorr for 20 hours. Secondary drying wasachieved at a shelf temperature of 25° C. with a chamber pressure of 100mTorr for 10 hours. The vials were stoppered under vacuum.

The vials were then reconstituted using 1 mL of sterile WFI to give aformulation containing 100 mg/mL natalizumab. The samples were analyzedimmediately after lyophilization and after 2 wks of storage in thelyophilized form at 40 deg. In both cases reconstitution times wereimmediate. The reconstituted solutions were clear and colorless with anabsence of particulate material. The samples contained greater than 99%monomer by SEC, with no high molecular weight aggregate, or lowmolecular weight species. After 2 weeks storage at 40 deg, the sampleshowed 94% potency relative to reference (specification 80-125%).

All cited patents and publications referred to in this application areherein incorporated by reference in their entirety for all purposes.

What is claimed is:
 1. A stable, aqueous pharmaceutical formulationcomprising from about 20 mg/ml to about 150 mg/ml of natalizumab,polysorbate 80 present in an amount of about 0.0001% to 2% (w/v), about10 mM phosphate buffer, and about 140 mM NaCl.
 2. The formulation ofclaim 1, comprising about 150 mg/ml natalizumab.
 3. The formulation ofclaim 1, wherein the formulation is isotonic.
 4. The formulation ofclaim 1, wherein the formulation is stable at a temperature of 2° C. to8° C. for at least 6 months.
 5. The formulation of claim 1, wherein theformulation has a pH of 3.0 to 7.0.
 6. The formulation of claim 4,wherein the pH is 5.5 to 6.5.
 7. An article of manufacture comprising acontainer holding the stable, aqueous pharmaceutical formulation ofclaim
 1. 8. An article of manufacture comprising a container holding thestable, aqueous pharmaceutical formulation of claim
 2. 9. An article ofmanufacture comprising a container holding the stable, aqueouspharmaceutical formulation of claim
 3. 10. An article of manufacturecomprising a container holding the stable, aqueous pharmaceuticalformulation of claim
 4. 11. An article of manufacture comprising acontainer holding the stable, aqueous pharmaceutical formulation ofclaim
 5. 12. An article of manufacture comprising a container holdingthe stable, aqueous pharmaceutical formulation of claim 6.